Re: abnormal pap in pregnancy

From: ATFSOCCER@aol.com
Sat Oct 4 22:22:32 1997


In a message dated 97-10-04 04:04:08 EDT, you write:

<< Screening PAP showed adenocarcinoma cells X2 all reviewed by good >cytopathologists.
>Colposcopy and pelvic exam showed no abnormalities with normal cervical
>appearance and consistency. ECC showed poorly differentiated adenoca
>cells.
>Any suggestions for management ?
>She also want to have vaginal delivery if possible.

Amnio - if mature, CKC, frozen section -if invasive, Cesarean rad hyst/nodes -if equivocal, await permanent, if invasive, as above -if in situ, margins negative, NSD, hyst in 4-6 wks

- if immature, wait until 35 to 36 weeks, then plan as above

A.C. Evans, M.D., Ph.D. Division of Gynecologic Oncology Univ. of Utah, Salt Lake City (801) 581-7640 >>

AC

Assuming that she has stage 1 disease, of course? I would suggest as well, that if the permanent is CIS that you could offer another option besides hysterectomy. That being SVD with repeat pap and colposcopy and ECC in 6 weeks to check for a "cure".

Andy Folley MD FACOG Toledo OH





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